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Kytffi <br />Yail'r Htwe frr Hookh <br />KVH Workplace Health <br />Company Name Kittitas County Sheriff's Office <br />Physical Street Address:307 W. Umptanum Rd <br />City, State, Zip:Ellensburg, WA 98926 <br />Mailing Address (if different from physical) <br />Primary Contact:Kim Dawson <br />Office Phone s09-962-7089 <br />Contact Email:Kim.dawson @co. kittitas.wa. us <br />Office Fax: <br />Secondary Contact (if applicable) <br />Secondary Contact Phone <br />ECheck if the same as physicaladdress <br />Company Name: <br />Street Address (Mailine): <br />City, State, Zip <br />Phone: <br />Fax <br />Physical Examination nstandard: $100 <br />Audiogram nstandard: S55 <br />Venipuncture nstandard: S22 <br />Exec 1 Panel Dstandard:5gg <br />Non-Federal Drug Screen, 5 panel nstandard: S+s <br />EKG nstandard: $75 <br />U/A with micro Istandard: Szz <br />StoolGuaiac nstandard:5q0 <br />Range of Motion !standard:5q5 <br />Spirometry nstandard: $60 <br />PA Chest X-Ray (1 view)lstandard: 5100 <br />L Spine X-Ray flstandard: $60 <br />T Spine X-Ray trstandard: 560 <br />Optional Services <br />Hep B Titer flstandard: 560 <br />Hep B lnjections, each (series of 3)nstandard: 5103 <br />PSA (if medically indicated)Estandard:5100 <br />Total w/o Optional Services Sttz